The objectives were to determine whether or not manual hyperinflation (MHI) is used as a treatment technique by physiotherapists on respiratory compromised patients in intensive care units (ICU), to determine physiotherapists‟ knowledge on the use of MHI (indications, contra-indications, treatment effect) as a treatment technique on respiratory compromised patients in ICU, to compare the physiotherapists‟ knowledge on the use of MHI to their utilisation of MHI in ICU, and to determine whether the effect of clinical experience has an influence on physiotherapists‟ decision making regarding the use of MHI in the ICU setting. The last objective was to investigate whether the working environment has an influence on the utilisation of MHI by physiotherapists practicing in adult ICUs in South Africa.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2016 / Mechanical ventilation is a life-saving and frequently used treatment modality in a variety of medical diagnosis in the intensive care unit (ICU). Despite that fact, mechanical ventilation can be a distressing experience for the patient, and may result in anxiety and discomfort. In recent years, light or no sedation and the practice of wake-up calls have become common approaches allowing the patient to be more awake during mechanical ventilation. Little is known about how patients experience this particular aspect of ICU treatment in light of changes in sedation practices. This study explored and described the experiences of patients on mechanical ventilation in the intensive care unit of one public sector hospital in Johannesburg. A qualitative, descriptive and explorative design was used and ten mechanically ventilated patients were recruited from the intensive care units of one public sector hospital in Johannesburg. The data was collected using audio-taped in-depth interviews to keep a record of the actual information presented by the participants. The collected data was transcribed and the information was analysed using Clarke and Braun’s (2013) descriptive method. A general expression from the participants was the fact that being connected to a ventilator induces a physical and emotional discomfort. The data analysis identified three themes which were (i) physical experiences, (ii) emotional experiences and (iii) communication. The participants described their experiences of breathlessness, mouth dryness, pain and physical discomfort as a result of being placed on the ventilator which caused the physical experiences for the patients. The experiences of bothering, fear of unknown, anxiety, feeling shocked and frightened at the moment of waking up from anaesthesia culminated into an emotional experience for the patients. The participants described that the extubation process has hard and difficult to endure, also powerlessness, loss of body image and control and near death experiences were findings of the participants. The lack of information was viewed by the participants in terms of being connected to mechanical ventilation as an important component of the recovery period, the benefit of purpose of connection during this period and the weaning process although, some of the participants alluded to receiving a measure of information but described it as inadequate to prepare them emotionally for the procedure. The short time for visitation and family presence was also evident in this study as impacting on the emotional state of the participants. In the midst of these unpleasant experiences, most of the participants appreciated the caring attitude of the ICU nursing staff which gave them a sense of comfort and safety. The findings of this study further showed that administration of sedation to some of the participants affected their memory as they could not recollect things that happen while in the ICU. Communication was the third theme that emerged from this study as findings revealed that the participants were not happy with the inability to talk as a result of the endotracheal tube. Nevertheless, the use of alternative communication methods such as the use of sign language, writing, scribbling on paper and lip reading gave the participants a bit of a relief. The findings of this study support the previous findings of the experiences of patients on mechanical ventilation. The findings add to the body of knowledge from the South African context as little is known regarding the patients experiences of mechanical ventilation from the South African context and Africa at large. As the field of intensive care nursing is growing in the African continent, it becomes imperative for research to be conducted in order to determine the clinical, educational and managerial gaps in ICU focusing more on measures to reduce these unpleasant experiences, increase evidence based practise and nursing perspectives. It may be appropriate for this study to be replicated in other private and public institution on a larger scale to compliment these findings. / MT2017

Bakgrund: Förekomsten av delirium på intensivvårdsavdelningar är stor, cirka 80% av patienterna som vårdas på intensiven drabbas vid något tillfälle av delirium. Patienter beskriver en rädsla då delirium medför vanföreställningar och hallucinationer. Oupptäckt delirium orsakar ett lidande hos patienten och kan medföra konsekvenser för patienten såväl som samhället. Syfte: Syftet med studien är att beskriva intensivvårdssjuksköterskors erfarenheter av att vårda patienter med delirium. Metod: En integrativ litteraturstudie av 20 artiklar enligt Whittmore och Knafl. Resultat: I resultatet identifieras två teman. (1) Att uppleva okunskap och osäkerhet vid vårdandet av patienter med delirium och (2) Att arbeta omsorgsfullt. Att få tillräckligt med utbildning och ha tydliga riktlinjer är en viktig faktor för intensivvårdssjuksköterskor i hanteringen av delirium. Ökad kunskap leder till ökat självförtroende vilket i sin tur leder till tidigare upptäckt och snabbare behandling för patienten. Slutsats: Examensarbetet presenterar intensivvårdssjuksköterskors erfarenheter av att identifiera och behandla patienter med delirium. Delirium är underdiagnostiserat vilket betonar viken av att intensivvårdssjuksköterskor besitter adekvat kompetens I ämnet.

No description available.

Sammanfattning  Bakgrund: Arbetet i en operationssal kräver effektivt samarbete mellan olika yrkesgrupper. Anestesisjuksköterskan och anestesiläkaren jobbar nära varandra, men utmaningar uppstår ofta på grund av skillnader i yrkesroller, hierarkiska strukturer och överlappning av ansvarsområden. Anestesisjuksköterskors attityder till samarbete är generellt mer positiva än anestesiläkares. Relationen mellan dessa två yrkesgrupper är också den främsta källan till stress för anestesisjuksköterskor, vilket kan påverka både arbetsmiljön och patientsäkerheten negativt.   Syfte: Att beskriva anestesisjuksköterskors upplevelser av att samarbeta med anestesiläkare på en anestesiavdelning.     Metod: En beskrivande intervjustudie med kvalitativ ansats. Semistrukturerade intervjuer har genomförts med fem anestesisjuksköterskor på en operationsavdelning i Mellansverige. För att analysera intervjuerna användes en kvalitativ innehållsanalys.   Resultat: Anestesisjuksköterskans upplevelse av att samarbeta med anestesiläkaren vid anestesi presenteras i tre kategorier: ”Uppfattningar om samarbete”, ”Förutsättningar för ett fungerande samarbete”, ”Utmaningar för ett fungerande samarbete”, samt nio underkategorier: ”Positiv syn på samarbetet”, ”Vikten av samarbete”, ”Tydlig kommunikation”, ”Planering för anestesi”, ”Inflytande i beslutsprocessen”, ”En god arbetsrelation”, ” Variation i anestesiläkares preoperativa bedömningar”, ”Arbetserfarenhets påverkan” samt ”Stresspåverkan”.   Slutsats: Samarbetet mellan anestesisjuksköterskor och anestesiläkare var övervägande positivt. Vikten av tydlig kommunikation, planering för anestesi, inflytande i beslutsprocessen och en god arbetsrelation betonades. För att förbättra samarbetet föreslås träning i kommunikationsfärdigheter och främjande av delaktighet i beslutsprocessen. Implementering av riktlinjer för konsensusbeslut och mentorstöd till nya ST-läkare kan öka effektiviteten. Dessutom kan tillhandahållande av stresshanteringsstrategier och personligt stöd hjälpa anestesisjuksköterskor och anestesiläkare att hantera stress i svåra situationer. / Abstract Background: Work in an operating room requires effective collaboration among various professional groups. The nurse anesthetist and the anesthesiologist work closely together, but challenges often arise due to differences in professional roles, hierarchical structures, and overlapping responsibilities. Nurse anesthetists generally have more positive attitudes towards collaboration than anesthesiologists. The relationship between these two professional groups is also the primary source of stress for nurse anesthetists, which can negatively affect both the work environment and patient safety.   Purpose: To describe nurse anesthetists’ experiences of collaborating with anesthesiologists in an anesthesia department.   Method: A descriptive interview study with a qualitative approach was conducted. Semi-structured interviews were carried out with five nurse anesthetists in an operating department in central Sweden. A qualitative content analysis was used to transcribe and analyze the interviews.   Result: The nurse anesthetist’s experience of collaborating with the anesthesiologist during anesthesia was presented in three categories: "Perceptions of collaboration", "Prerequisites for functional collaboration", "Challenges for functional collaboration", and nine subcategories: "Positive view of collaboration", "Importance of collaboration", "Clear communication", "Planning for anesthesia", "'Influence in the decision-making process", "A good working relationship", "Variation in anesthesiologists’ preoperative assessments ", "Impact of work experience" and "Impact of stress".   Conclusion: The collaboration between nurse anesthetists and anesthesiologists was mostly positive. Emphasis was placed on communication, planning, shared decision-making, and work relationships. To enhance collaboration, training in communication skills and encouraging participation in decision-making are recommended. Implementing consensus decision guidelines and providing mentorship support to new residents can improve efficiency. Offering stress management strategies and personal support can assist nurse anesthetists and anesthesiologists in coping with stress.

M.Cur. / The purpose of this study was to describe the clinical competencies of the shift leader in the ICU setting in order to determine if there is a gap between what is expected of the shift leader and what is happening in reality. A quantitative, descriptive design was used and cluster sampling implemented. A survey, utilizing questionnaires, was used to gather data from three clusters, comprising 11 hospitals from a single private healthcare group. 251 questionnaires were distributed and 98 were returned, indicating a response rate of 39%. Validity and reliability were ensured. Results indicated that respondents classified the majority of competencies as essential competencies. None were classified as critical competencies and only four were classified as specific competencies. Shift leaders were viewed as competent by all respondents in all three clusters. Results were used to describe a typology of the competencies of the shift leader in the ICU setting.

Thesis (LL.M.). / Written for the Biomedical Ethics Unit, Faculty of Law. Title from title page of PDF (viewed 2008/12/04). Includes bibliographical references.

Thesis (M.Nurs.)--Edith Cowan University, 2009. / Submitted to the Faculty of Computing, Health and Science. Includes bibliographical references.

Thesis (M.H.A.)--University of Michigan, 1957.

Thesis (M.S.)--University of Michigan, 1976.